Objective: To identify the relationship between the expression of protein tyrosine phosphatase non-receptor type 12 (PTPN12) and radiotherapy effect in non-small cell lung cancer (NSCLC) tissues and to determine whether PTPN12 deficiency can sensi-tize lung cancer cells to irradiation. Methods: From September 2013 to October 2014, 92 NSCLC patients undergoing radiotherapy with or without platinum-based combination chemotherapy were analyzed retrospectively. Before the treatment, PTPN12 expression was detected through immunohistochemistry. After the completion of radiotherapy, the patients' responses were assessed and radio-therapeutic efficacy analyzed. The human NSCLC cell line H1299 was infected with shPTPN12 knockdown, and colony survival assay was analyzed after irradiation. Chi-square test was used to examine the correlation between PTPN12 expression and clinicopathologi-cal characteristics. Univariate analyses and Logistic regression test were used to analyze the relationship between clinicopathological characteristics and radiotherapeutic response. Results: Patients with low PTPN12 expression were more sensitive to radiotherapy than those with high PTPN12 expression (80.0%vs. 57.1%, P=0.018). Multivariate analysis showed that PTPN12 expression was the on-ly independent predictor of radiotherapeutic response in NSCLC. The H1299-shPTPN12-knockdown cells were sensitive to irradiation. Conclusions:The results of the study indicated that downregulation of PTPN12 improved the radiosensitivity of NSCLC cells.

The Singapore public healthcare system has increasingly used the term "right-siting" to describe the principle that stable chronic disease patients should be managed in primary care rather than specialist settings. The majority of primary healthcare providers in Singapore are general practitioners (GPs). The aims of this paper were to measure the quality of diabetes care in specialist and GP settings, and assess right-siting efforts in a tertiary centre in Singapore. Three hundred eighty-three consecutive patients with type 2 diabetes referred to the Singapore General Hospital Diabetes Centre (SGH DBC) between January and March 2005 were analysed. At the first visit, 51 patients (13.3%) were classified as inappropriate referrals and discharged back to the referral source or to primary care. After 12 months, 136 patients (group A = 35.5%) remained on follow-up at SGH DBC. In these patients, significant improvements were seen in mean HbA1c but not blood pressure (BP) or low density lipoprotein-cholesterol (LDL-C). One hundred twenty-eight (group B = 33.4%) patients were discharged from DBC within the 12 months of the study period. Mean follow-up duration in group B was 5.5 months and HbA1c, blood pressure and LDL-cholesterol had improved significantly in these patients. Glycaemic control of group B patients at the time of discharge was significantly better than group A at 12 months (mean HbA1c = 7.15% vs 8.16%; P <0.001). More than half (55.6%) of group B patients achieved HbA1c targets compared to 32.4% from group A (P <0.001). Although mean BP and LDL-C levels fell in group B patients, the percentage of patients achieving BP and LDL-C targets did not improve significantly in both groups. From August 2005 to January 2008, GPs participating in SingHealth's Delivering on Target (DOT) programme enrolled 579 patients under their care for additional diabetic counselling by community nurse educators. Pre- and post-programme HbA1c results were submitted for 370 patients (64%). Mean HbA1c levels of these patients decreased from 8.23% to 7.32% (P <0.001). The proportion of patients who achieved HbA1c <7% increased from 26% to 51% (P <0.01). However, BP and LDL-C levels did not improve. It is difficult to base referral or discharge decisions solely on these indicators. Our studies show that both in the specialist and GP settings, significant improvements in HbA1c are seen. Results for BP and LDL-C, however, showed little improvement. Some degree of rightsiting was seen at SGH DBC with discharged patients showing greater improvements than patients who were retained. However, >30% of patients remained in SGH DBC despite achieving HbA1C targets. Our results indicate the need for better strategies to address the underlying obstacles to right-siting. Of greater concern, the lack of improvement in BP and LDL-C indicates a high degree of clinical inertia to these issues among specialists and GPs treating diabetes in Singapore.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blood Glucose ; metabolism ; Blood Pressure ; Cholesterol, LDL ; blood ; Delivery of Health Care, Integrated ; methods ; standards ; Diabetes Mellitus ; blood ; physiopathology ; therapy ; Female ; Follow-Up Studies ; Glycated Hemoglobin A ; metabolism ; Humans ; Middle Aged ; Outcome Assessment (Health Care) ; methods ; Primary Health Care ; methods ; standards ; Retrospective Studies ; Singapore ; Young Adult

Over the past few years, the human virome and its complex interactions with microbial communities and the immune system have gained recognition as a crucial factor in human health. Individuals with compromised immune function encounter distinctive challenges due to their heightened vulnerability to a diverse range of infectious diseases. This review aims to comprehensively explore and analyze the growing evidence regarding the role of the virome in immunocompromised disease status. By surveying the latest literature, we present a detailed overview of virome alterations observed in various immunodeficiency conditions. We then delve into the influence and mechanisms of these virome changes on the pathogenesis of specific diseases in immunocompromised individuals. Furthermore, this review explores the clinical relevance of virome studies in the context of immunodeficiency, highlighting the potential diagnostic and therapeutic gains from a better understanding of virome contributions to disease manifestations.
Humans ; Viruses ; Virome ; Microbiota ; Immunologic Deficiency Syndromes